Intrapartum Heart Rate Ambiguity: A Comparison of Cardiotocogram and Abdominal Fetal Electrocardiogram with Maternal ElectrocardiogramReinhard J. · Hayes-Gill B.R. · Schiermeier S. · Hatzmann H. · Heinrich T.M. · Louwen F.
aDepartment of Obstetrics and Gynaecology, Faculty of Medicine, Johann Wolfgang Goethe University Frankfurt am Main, Frankfurt am Main, Germany; bSchool of Electrical and Electronic Engineering, University of Nottingham, University Park, Nottingham, UK; cObstetrics and Gynaecology, Faculty of Medicine, Marien Hospital Witten, University Witten/Herdecke, Teaching Hospital of the Ruhr University Bochum, Witten, Germany
Objective/Aims: To investigate the presence of signal ambiguity of intrapartum fetal heart rate (FHR) monitoring during delivery by comparing simultaneous cardiotocogram (CTG), abdominal fetal electrocardiogram (ECG) with continuous maternal ECG. Methods: A total of 144 simultaneous CTG (Corometrics© 250 series), abdominal fetal ECG (Monica -AN24™) and maternal ECG (Monica AN24™) recordings were evaluated. Main Outcome Measures: When the FHR is within 5 bpm of the maternal heart rate (MHR) acquired from the ECG, it is classified as ‘MHR/FHR ambiguity'. Statistical analyses were performed with Fisher's exact test and the Wilcoxon signed-rank test. Results: Comparison of abdominal fetal ECG against CTG demonstrates significantly less ‘MHR/FHR ambiguity' in both the first stage (mean 0.70 vs. 1.22%, p < 0.001) and second stage of labour (mean 3.30 vs. 6.20%, p < 0.001). Conclusion: Intrapartum FHR monitoring in daily practice via the CTG modality provides significantly more ‘MHR/FHR ambiguity' than abdominal fetal ECG, which also provides additional information on the MHR.
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